Much like the Berlin Wall in 1989, the rigid structure of the German healthcare sector is beginning to crumble.
"The German discussion in reforming the healthcare sector was dominated by taboos; now taboos exist no longer," says Volker Leienbach, managing director of the German Association for Social Insurance Policy and Research, a private umbrella organization that links players in the German healthcare sector--doctors, hospitals, social insurance funds and private insurers--to discuss topics of common concern and develop health policy initiatives.
Leienbach will serve as one of five experts on a panel discussion titled "Germany: Private Health Sector Investment--Opportunities and Obstacles."
Driven by growing consumer demand and new open-mindedness, Germans are breaking with longstanding healthcare traditions and practices. Leienbach said in Germany there is now a blurring of the line separating the private insurance market and the government-mandated social insurance funds.
He also said his country is experimenting with selective contracting of providers based on quality and economic criteria.
"Health was always a social issue (for Germans)," Leienbach says. "Now, we are just realizing that it is an economic issue as well."
Leienbach said he thinks foreign investment in his country's healthcare sector is worthwhile and the opportunities are substantial.
"If you look at the preferences of the people, you will see that health is No. 1."
German citizens obtain health insurance, depending on their income, through either a social insurance fund or a private insurance company. Approximately 90% of the country's 82 million population receive a government-guaranteed set of basic health benefits through the social insurance system. The other 10%, typically those with higher incomes, purchase private insurance; giving them access to more senior doctors, better hospital rooms and a broader list of healthcare services. There has been growth in the number of those with social insurance who are supplementing their basic insurance package by purchasing some private insurance, Leienbach says. The extra coverage allows them more choice in providers and access to services not covered in the social insurance package, such as complementary medicine.
This burgeoning demand for more and better services is exposing some shortcomings in Germany's inflexible delivery systems. Also, the German Ministry of Health has mandated that hospitals be reimbursed by 2003 under a prospective payment system. And German providers just aren't prepared for that change, Leienbach says.
Germany also needs to develop better patient-information systems and electronic medical records, he says.
"Germany is no doubt behind in these management tools and with information technology in the healthcare sector," Leienbach says.